Ex vivo retrieval and cryopreservation of oocytes from oophorectomized specimens for fertility preservation in a BRCA1 mutation carrier with ovarian cancer

Ex vivo retrieval of mature oocytes from oophorectomized specimens can be utilized in patients with malignant ovarian tumors, for whom conventional follicular puncture may cause iatrogenic tumor seeding and upstaging.

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Volume 108, Issue 2, Pages 357–360

Authors:

Nigel Pereira, M.D.Nigel Pereira, Andrea G. Hubschmann, M.D., Jovana P. Lekovich, M.D., Glenn L. Schattman, M.D., Zev Rosenwaks, M.D.

Abstract:

Objective

To report a case of ex vivo oocyte retrieval from oophorectomized specimens in a BRCA1 mutation carrier undergoing surgical staging for ovarian cancer.

Design

Video case report and literature review.

Setting

University-affiliated center.

Patient(s)

A 37-year-old single woman, gravida 0, with a known BRCA1 mutation, presented to her oncologist with a complex right ovarian mass and elevated CA-125 level. Ovarian cancer was suspected, and the patient consented to complete surgical staging. Although she desired to cryopreserve oocytes for fertility preservation, conventional oocyte retrieval was deemed unsafe because follicular puncture would compromise the integrity of the ovarian capsule, thereby increasing the risk of malignant cell spillage and cancer upstaging.

Intervention(s)

Luteal-phase ovarian stimulation with gonadotropins and letrozole was performed. Surgical staging was initiated 34 hours after the administration of the ovulatory trigger.

Main Outcome Measure(s)

Ex vivo retrieval of oocytes from bilateral oophorectomized specimens under direct visualization at the time of surgical staging.

Result(s)

Seven mature oocytes were retrieved and vitrified. Concomitant surgical staging was completed.

Conclusion(s)

The present case highlights the feasibility of ex vivo or extracorporeal retrieval of mature oocytes from oophorectomized specimens in patients with ovarian cancer. By avoiding follicular puncture within the pelvic cavity, it minimizes the risk of malignant cell spillage and cancer upstaging.


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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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